Depression and diabetes: Establishing the pharmacist's role in detecting comorbidity in pregnant women

Abstract

ObjectivesTo determine the prevalence of depression in women with diabetes receiving prenatal care and to determine whether pregnant women with comorbid depression and diabetes are receiving adequate care for depression. SettingLittle Rock, AR, between June and August 2007. Practice descriptionAt a women's health clinic providing obstetrical services to local and statewide patients, the clinical pharmacist functions as a diabetes educator, provides treatment recommendations for the OB/GYN medical residents, and precepts fourth-year student pharmacists. Practice innovationThe pharmacist and student pharmacists screened patients with diabetes for depression using the Beck Depression Inventory, 2nd ed. (BDI-II). Main outcome measuresPatient demographics, including obstetrical history, type of diabetes, depression history, and current treatments. Results50 patients were screened in this pilot study. Of participants, 42% reported scores that indicated clinical depression. Among patients with clinical depression, only 19% were receiving treatment for depression. Obstetrical history (number of pregnancies) showed a positive correlation with the BDI-II total scores (P = 0.0078). ConclusionThis population had a high prevalence of depressive symptoms, but very few women were receiving treatment for depression. Depression screenings should be integrated into routine prenatal care, offering adequate treatment when needed. This study implies that pharmacists can assist with screening for depression in diabetes and thus ensure that at-risk patients receive the attention needed to better manage their illnesses.